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PubMed2006

Smoking and postprandial triglycerides are associated with vascular disease in patients with type 2 diabetes.

AIMS: To determine whether postprandial lipid levels are markers of clinical and subclinical macrovascular disease in a select group of patients with type 2 diabetes. METHODS: We recruited 119 local patients with type 2 diabetes and moderate metabolic control (HbA1c <8%). The patients were being treated with dietary measures and/or oral antihyperglycemic therapy. No patient was receiving lipid-lowering therapy. A history of cardiovascular events was recorded and the ankle-arm index was measured to assess subclinical peripheral artery disease. The patients underwent a lipid analysis after a 12-h fast and 4h after a mixed breakfast (50 g of fat, 40 g of carbohydrates). RESULTS: The patients with clinical and subclinical macrovascular disease had a greater history of smoking, a longer disease duration, and higher serum creatinine levels. The groups with macroangiopathy had lower postprandial concentrations of HDL cholesterol (p<0.05) and a trend towards lower fasting levels of HDL cholesterol (p=0.08) and higher fasting and postprandial levels of triglycerides (p=0.07). Multivariate analysis showed the presence of vascular (both clinical and subclinical) disease to be significantly associated with smoking (OR 3.06; 95% CI, 1.15-8.4), disease duration (for each year, OR 1.12; 95% CI, 1.03-1.22) and postprandial levels of triglycerides (for each 50mg, OR 1.73; 95% CI, 1.13-2.65). CONCLUSIONS: In our diabetic patients, the postprandial level of triglycerides 4h after a fatty breakfast, though not fasting lipids, plus smoking and disease duration were independently associated to clinical and subclinical macrovascular disease.

Aged↗

PubMed2004

Oral supplements differing in fat and carbohydrate content: effect on the appetite and food intake of undernourished elderly patients.

BACKGROUND & AIMS: Since fat, relative to other macronutrients, has low satiety and high energy density, it may have therapeutic application for supplementing energy intake. This study compared the effect of isoenergetic (1050 kJ) high fat or high carbohydrate oral supplements, given at breakfast, on the short-term appetite and energy intake in undernourished elderly subjects. METHODS: Sixteen hospitalised, undernourished (body mass index: 20 +/- 3 kg/m2), elderly (77 +/- 8 yr) people were randomly allocated to a control or 1 of 2 supplement groups [fat: carbohydrate: protein (% energy) was 70:25:5 or 25:70:5]. In each group, energy intake (24-h food consumption) and appetite (visual analogue scales) were assessed over 3 consecutive days. RESULTS: Mean energy intake significantly (P = 0.0035) increased following supplementation: high fat 6973 kJ/d, high carbohydrate 6906 kJ/d vs. control 6079 kJ/d but mean voluntary 24-h energy intake remained unaffected. Compared to controls, supplemented subjects experienced reduced hunger (P = 0.07) between breakfast and lunch, but showed no difference over the whole day (P = 0.55). CONCLUSIONS: Under these study conditions a 1050 kJ oral supplement, irrespective of macronutrient composition, does not cause voluntary short-term energy intake compensation in undernourished elderly people.

Administration, Oral↗

PubMed2006

Survey of dietary habits in obese patients with type 2 diabetes treated with either OHA or insulin injections in Japan.

A questionnaire survey on meal/snack intake and timing in obese patients with type 2 diabetes treated with either oral hypoglycemic agents (OHA) or insulin injections was performed in order to elucidate their dietary habits, using a method independent of the treating physician. The OHA and insulin groups recruited from all over Japan showed no differences in any factors except the duration of diabetes. Daily calorie intake was not correlated with gender, BMI, medication or HbA1c. However, calorie intake was the highest at dinner, followed by lunch and breakfast. Only for dinner was the calorie intake significantly higher for the OHA group than for the insulin group. Of the patients, 8.6, 4.2 and 1.3% skipped breakfast, lunch or dinner, respectively. However, there was no significant difference in the abstention ratio for the three meals or between the two treatment groups. It was remarkable that at least 90% or more reported the habitual ingestion of snacks. The snack time ranged from 6:00 a.m. to midnight. There was no marked difference in the proportion of patients having snacks between the two treatment groups. The outcomes such as deviations in calorie intake among the three meals, skipping meals and snacking in this survey may reflect the current dietary habits of obese patients with type 2 diabetes, especially under medical treatment.

Adult↗

PubMed2006

Insulin glulisine imparts effective glycaemic control in patients with Type 2 diabetes.

INTRODUCTION: Insulin glulisine (glulisine) was evaluated versus regular human insulin (RHI) in Type 2 diabetes (T2DM) patients. METHODS: Patients previously on >6 months' continuous insulin treatment aged >or=18 years in a randomized, multinational, controlled, open-label, parallel group, 26-week study received twice-daily NPH insulin and either glulisine (0-15 min before breakfast and dinner; n=448) or RHI (30-45 min before breakfast and dinner; n=442) at least twice daily. RESULTS: Mean baseline characteristics were similar between groups. There were no differences in baseline to endpoint HbA(1c) reductions (glulisine: -0.32%; RHI: -0.35%; p=0.5726), and the non-inferiority of glulisine versus RHI was demonstrated (difference in adjusted mean change 0.03%; 95% CI: -0.07, 0.13). Postprandially, glulisine lowered plasma glucose significantly more versus RHI at 2h (14.14 mmol/L versus 15.28 mmol/L; p=0.0025) and excursions at 1h (3.99 versus 4.59; p=0.0151) and 2h (4.87 versus 6.03; p=0.0002). No between-group differences occurred in the frequencies and monthly rates of all symptomatic hypoglycaemia; nocturnal hypoglycaemia from Month 4 to treatment end was less frequent with glulisine versus RHI (9.1% versus 14.5%; p=0.029). CONCLUSION: Glulisine was non-inferior to RHI in reducing HbA(1c) in T2DM. Glulisine demonstrated superior postprandial glucose control and was associated with fewer nocturnal hypoglycaemic episodes, indicating clinical benefits.

Administration, Oral↗

PubMed2004

Twice daily (mid-day and evening) quadruple therapy for H. pylori infection in the United States.

BACKGROUND: Quadruple therapy provided inadequate eradication rate when given twice-a-day at breakfast and evening meals. AIM: To test twice daily (mid-day and evening) quadruple therapy for Helicobacter pylori eradication. METHODS: This was a single-centre pilot study in which H. pylori-infected (positive histology and culture and RUT) patients were given 2 x 250 mg of metronidazole and 2 x 250 mg of tetracycline, two Pepto-Bismol tablets, plus one 20 mg rabeprazole tablet twice-a-day for 14 days. H. pylori status was confirmed 4 or more weeks after the end of therapy. RESULTS: Thirty-seven patients including 3 with peptic ulcer disease, 19 asymptomatic infected, 4 GERD, and 11 with NUD. Mid-day quadruple therapy was successful in 92.3% (95% CI: 79-98%) including 96.2% of those with metronidazole-susceptible strains, and in 83.3% (10/12) of those with metronidazole-resistant H. pylori. Compliance was 100% by pill count except in one individual who stopped medication after 12 days because of side-effects and who failed therapy. Moderate or greater side-effects were experienced by five patients. CONCLUSION: Twice-a-day, mid-day, quadruple therapy proved effective using the combination of bismuth subsalicylate and rabeprazole instead of bismuth subcitrate and omeprazole. Detailed studies of different formulations (e.g. 2 x 250 mg versus 1 x 500 mg of metronidazole or tetracycline) and timing of administration (breakfast and evening meal versus mid-day and evening meals) may result in significant improvements in H. pylori eradication regimens.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2004

In vitro assessment of the upper gastrointestinal tolerance of potential probiotic dairy propionibacteria.

This study aimed to assess the transit tolerance of potential probiotic dairy propionibacteria strains in human upper gastrointestinal tract in vitro, and to evaluate the effect of food addition on viability of these strains in simulated pH 2.0 gastric juices. The transit tolerance of 13 dairy propionibacteria strains was determined at 37 degrees C by exposing washed cell suspensions to simulated gastric juices at pH values at 2.0, 3.0, and 4.0, and simulated small intestinal juices (pH 8.0) with or without 0.3% bile salts. The viability of dairy propionibacteria in pH 2.0 simulated gastric juice with So-Good original soymilk or Up & Go liquid breakfast was also determined. The simulated gastric transit tolerance of dairy propionibacteria was strain-dependent and pH-dependent. All tested strains were tolerant to simulated small intestinal transit. The addition of So-Good original soymilk or Up & Go liquid breakfast greatly enhanced the survival of dairy propionibacteria strains in pH 2.0 simulated gastric juices. Dairy propionibacteria strains demonstrate high tolerance to simulated human upper gastrointestinal tract conditions and offer a relatively overlooked, yet alternative source for novel probiotics besides Lactobacillus and Bifidobacterium.

Colony Count, Microbial↗

PubMed2005

Phenolic content of virgin olive oil improves ischemic reactive hyperemia in hypercholesterolemic patients.

OBJECTIVES: The goal of this study was to evaluate the effects of the phenolic content of virgin olive oil on endothelial reactivity. BACKGROUND: Endothelial-dependent vasodilatation is impaired during the postprandial state, and oxidative stress could play a key role in its development. METHODS: Twenty-one hypercholesterolemic volunteers received two breakfasts, using a randomized sequential crossover design. Both arms received the same olive oil, but one had its phenolic acid content reduced from 400 to 80 ppm. Ischemic reactive hyperemia (IRH) was measured with a laser-Doppler procedure at baseline and 2 h and 4 h after oil intake. Postprandial plasma concentrations of lipid fractions, lipoperoxides (LPO), 8-epi prostaglandin-F(2alpha), and nitrates/nitrites (NO(x)) were obtained at baseline and after 2 h of the fat meal. RESULTS: The intake of the polyphenol-rich breakfast was associated with an improvement in endothelial function, as well as a greater increase in concentrations of NO(x) (p < 0.001) and a lower increase in LPO (p < 0.005) and 8-epi prostaglandin-F2alpha (p < 0.001) than the ones induced by the low polyphenol fat meal. A positive correlation was found to exist between NO(x) and enhanced endothelial function at the second hour (r = 0.669; p < 0.01). Furthermore, a negative correlation was found between IRH and LPO (r = -0.203; p < 0.05) and 8-epi prostaglandin-F2alpha levels (r = -0.440; p < 0.05). CONCLUSIONS: A meal containing high-phenolic virgin olive oil improves ischemic reactive hyperemia during the postprandial state. This phenomenon might be mediated via reduction in oxidative stress and the increase of nitric oxide metabolites.

Aged↗

PubMed2004

Meal and snack patterns of infants and toddlers.

OBJECTIVE: To describe meal and snack patterns of infants and toddlers. DESIGN: A cross-sectional telephone survey in which mothers reported their infants' and toddlers' food and beverage intakes for a 24-hour period. SUBJECTS: Subjects included 3,022 infants and toddlers, ages 4 to 24 months, in the Feeding Infants and Toddlers Study. STATISTICAL ANALYSES PERFORMED: Means+/-standard deviations, frequencies, percentages, energy and nutrient analyses, nutrient densities. RESULTS: On average, infants and toddlers were fed seven times per day. The breakfast, lunch, and dinner pattern, plus snacks, emerged at 7 to 8 months and was well established by 9 to 11 months. Breakfasts were higher in nutrient density for iron, folate, and calcium than other meals. The percentage of children reported to be eating snacks increased with age. The afternoon snack was consumed by over 80% of toddlers (12 to 24 months), and snacks provided about 25% of toddlers' daily energy intakes. Typical snack foods for toddlers were milk, water, cookies, crackers, chips, and fruit drinks. APPLICATIONS/CONCLUSIONS: Results of this study provide parents and professionals with specific information about meal and snack patterns, thereby allowing development of targeted messages and/or strategies to improve the dietary patterns of infants and toddlers. Although most foods provided to the Feeding Infants and Toddlers Study infants and toddlers were nutritionally and developmentally appropriate, snack choices could be improved by delaying introduction of and limiting exposures to foods low in nutrients and high in calories.

Age Factors↗

PubMed2006

Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults.

OBJECTIVE: This study was undertaken to test the hypothesis that specific meal and snack patterns are associated with selected nutrient intakes in US adults. DESIGN: Using the 24-hour dietary recall from the Third National Health and Nutrition Examination Survey, meal and snack patterns were described in relation to nutrient intakes. SUBJECTS: The study included US adults aged 20 years or older (n=15,978). STATISTICAL ANALYSES PERFORMED: All statistical analyses accounted for the survey design and sample weights. Linear regression analyses controlled for confounding factors, including energy intakes. Wald F tests were used for determination of significance between means of nutrient intakes by daily eating frequency or meal pattern groups. RESULTS: Daily eating frequency was positively related to carbohydrate, folic acid, vitamin C, calcium, magnesium, iron, potassium, and fiber intakes and inversely related to protein, total fat, cholesterol, and sodium intakes. Meal patterns were further categorized into the five most commonly reported meal and snack combinations by population percentages including breakfast (B), lunch (L), dinner (D), and > or =2 snacks (S) (31.6%); B, L, D and 1 S (15.4%); B, D and > or =2 S (13.1%); B, L, D (8.3%); and L, D and > or =2 S (7.6%). Groups reporting B, L, D and 1 S and B, L, D and > or =2 S had the highest intakes of all micronutrients examined except cholesterol, vitamin B-6, and sodium. Breakfast skippers (L, D and > or =2 S) had the lowest intakes of all micronutrients examined except sodium. CONCLUSIONS: Findings from this cross-sectional survey suggest that meal and snack patterns may be markers for nutrient intakes and therefore diet quality. Complete nutrient intakes should be considered in investigations of meal patterns and health outcomes.

Adult↗

PubMed2006

Potentially protective factors associated with healthful body mass index in adolescents with obese and nonobese parents: a secondary data analysis of the third national health and nutrition examination survey, 1988-1994.

OBJECTIVE: To identify factors potentially protective against obesity in 12- to 16-year-olds with one or two obese parents, and those with no obese parents. DESIGN: A secondary analysis of the Third National Health and Nutrition Examination Survey, 1988-1994. SUBJECTS/SETTING: A nationally representative sample of healthful weight, at-risk, or overweight adolescents with measured heights and weights (n=1,890). Subsamples with any obese parent (body mass index > or =30) and no obese parents (both with body mass index <25) were analyzed. STATISTICAL ANALYSES PERFORMED: Bivariate analyses examined the association of predictor variables (demographics, nutrient intake, and physical activity) on the outcome. Logistic regressions examined the likelihood of being healthful weight. SUDAAN software (release 7.5, 1997, Research Triangle Institute, Research Triangle Park, NC) was used to account for the sample design. RESULTS: Overall, 71% of subjects had a healthful weight, 29% were at risk or overweight. Factors associated with healthful weight included having two nonobese parents (odds ratio [OR]=5.4), only father obese (OR=4.9), only mother obese (OR=3.3), higher reading scores (OR=1.02), lower water consumption (OR=1.8), more exercise programs (OR=2.8), and higher energy intake (OR=2.0). For adolescents with any obese parent, factors potentially protective against obesity included being female (OR=2.2), higher household education (OR=1.1), lower water consumption (OR=2.0), and eating breakfast some days (OR=3.1) or everyday (OR=4.0). For adolescents with no obese parents, potentially protective factors included older age (OR=1.2), not having asthma (OR=2.6), more exercise programs (OR=6.1), and higher energy intake (OR=2.9). All P<.05. CONCLUSIONS: Interventions targeted at adolescents who are at risk because they have parents with obesity should employ a family approach focused on regular breakfast consumption.

Adolescent↗

PubMed2006

"You had peas today?": a pilot study comparing a Head Start child-care center's menu with the actual food served.

This study explored the types of food served at a Head Start child-care center compared with that center's monthly menus. The study design was direct observation of the food provided by a Head Start center throughout the school day (Monday through Friday; 8:45 am to 2:30 pm) from January 4 to June 20, 2002, and analysis of this center's monthly menus. The numbers of meals directly observed for each type of meal service were: breakfast (n=96), lunch (n=95), and afternoon snack (n=78). These meals were compared with six monthly menus. Of the 269 meals and snacks compared, only three breakfast meals and an "ethnic day" matched the meals described on the provided menu. These findings illustrate that this center's menu was not consistently followed and therefore could not be used as an estimate of the preschoolers' intake or used as an educational or informational tool for parents/caregivers. Future research should verify how common these findings are among other Child and Adult Care Food Program child-care centers. Results may provide direction for development of the US Department of Agriculture's Child and Adult Care Food Program training for foodservice workers and educational materials focusing on menu development, appropriate substitutions, and the importance of using menus as a nutrition education tool.

Child Day Care Centers↗

PubMed2006

Position of the American Dietetic Association: local support for nutrition integrity in schools.

It is the position of the American Dietetic Association that the schools and the community have a shared responsibility to provide all students with access to high-quality foods and school-based nutrition services as an integral part of the total education program. Educational goals, including the nutrition goals of the National School Lunch Program and the School Breakfast Program, should be supported and extended through school district wellness policies that create overall school environments that promote access to healthful school meals and physical activity and provide learning experiences that enable students to develop lifelong healthful eating habits. The National School Lunch and School Breakfast Programs are an important source of nutrients for school-age children, and especially for those of low-income status. The American Dietetic Association was actively involved in the 2004 reauthorization of these programs, ensuring access through continued funding, promoting nutrition education and physical activity to combat overweight and prevent chronic disease, and promoting local wellness policies. The standards established for school meal programs result in school meals that provide nutrients that meet dietary guidelines, but standards do not apply to foods and beverages served and sold outside of the school meal. Labeled as competitive foods by the US Department of Agriculture, there is a growing concern that standards should be applied to food in the entire school environment. Legislation has mandated that all school districts that participate in the US Department of Agriculture's Child Nutrition Program develop and implement a local wellness policy by the school year 2006-2007. Resources are available to assist in the development of wellness policies, and dietetics professionals can assist schools in developing policies that meet nutrition integrity standards.

Adolescent↗

PubMed2006

Calcium and dairy intakes of adolescents are associated with their home environment, taste preferences, personal health beliefs, and meal patterns.

OBJECTIVE: To identify correlates of calcium, dairy, and milk intakes among male and female adolescents. DESIGN: Cross-sectional study design. Adolescents self-reported measures pertaining to correlates on the Project EAT (Eating Among Teens) survey and completed a food frequency questionnaire at school. SUBJECTS/SETTING: Subjects were a total of 4,079 middle and high school students from Minneapolis/St Paul, MN, public schools. STATISTICAL ANALYSES PERFORMED: Multiple linear regression models based on social cognitive theory were examined by sex. RESULTS: Male adolescents reported higher daily intakes of calcium (male: 1,217+/-663 mg; female: 1,035+/-588 mg; P<0.001), dairy servings (male: 2.9+/-1.9; female: 2.4+/-1.7; P<0.001), and milk servings (male: 2.0+/-1.5; female: 1.5+/-1.4; P<0.001) than female adolescents. Calcium intakes of male adolescents were significantly and positively related to availability of milk at meals, taste preference for milk, eating breakfast, higher socioeconomic status, and social support for healthful eating; intakes were significantly and inversely related to consumption of soft drinks and fast food. Among female adolescents, availability of milk at meals, taste preference for milk, eating breakfast, higher socioeconomic status, personal health/nutrition attitudes, and self-efficacy to make healthful food choices were significantly and positively related to intakes; intakes were significantly and inversely related to fast-food consumption. Models of calcium intake explained 71% of the variance in male adolescents and 72% of the variance in female adolescents. CONCLUSIONS: Multicomponent interventions with a focus on the family environment are likely to be most effective in increasing calcium intakes among adolescents.

Adolescent↗

PubMedDate not supplied

Prandial insulin substitution with insulin lispro or insulin lispro mid mixture vs. basal therapy with insulin glargine: a randomized controlled trial in patients with type 2 diabetes beginning insulin therapy.

PURPOSE: To compare the effects of prandial insulin therapy focusing on postprandial glucose control vs. basal insulin therapy focusing on fasting glucose control in patients with type 2 diabetes. METHODS: This was an open-label, randomized, parallel, three-arm multicenter trial in patients with type 2 diabetes starting insulin treatment. Patients (n=159) were randomly assigned to 24-week treatment with 3x daily insulin lispro, 3x daily lispro mid mixture (MidMix; 50% lispro, 50% protaminated lispro), or 1x daily insulin glargine; oral antihyperglycemic agents were discontinued. Primary end point was the postprandial glucose excursion 2 h after breakfast at the end of study. Secondary outcomes included HbA1c, self-monitored blood glucose profiles, hypoglycemic episodes, body weight, and patient satisfaction. RESULTS: At the end of study, glucose excursions 2 h after breakfast were significantly lower with lispro and MidMix than with glargine (P<.001 for each vs. glargine): lispro, -0.6+/-2.0 mmol/l; MidMix, +0.8+/-2.4 mmol/l; glargine, +2.5+/-2.4 mmol/l. Fasting glucose decreases were significantly greater with glargine (-2.6+/-2.4 mmol/l) than with lispro or MidMix (-0.9+/-2.2 mmol/l; +0.9+/-1.8 mmol/l). Nevertheless, HbA1c decreased by 1.1% (lispro) and 1.2% (MidMix), vs. 0.3% with glargine. Hypoglycemic episodes were rare with 1-1.5 self-reported episodes per 100 patient-days. CONCLUSIONS: In patients with type 2 diabetes starting insulin, 3x daily prandial treatment with a rapid-acting analog focusing on postprandial glucose values enabled better control of postprandial and circadian blood glucose profiles than once-daily glargine, in spite suboptimal fasting glucose levels, which targets fasting glucose values. These results support studies suggesting that control of postprandial hyperglycemia plays a key role in achieving HbA1c targets.

Adult↗

PubMedDate not supplied

Acceptability of lower glycemic index foods in the diabetes camp setting.

OBJECTIVE: To determine the acceptability of lower glycemic index (GI) foods served at diabetes camp. DESIGN: Crossover design of standard and lower GI menus. SETTING: Three consecutive 5-day diabetes camp sessions. PARTICIPANTS: 140 youth, age 7-16, with type 1 or 2 diabetes. INTERVENTION: A standard camp cycle menu was reformulated to include 2 1/2 days of standard foods and 2 1/2 days of lower GI foods. MAIN OUTCOME MEASURES: Youth provided satisfaction ratings after meals and snacks using measures designed for this study. Observations of food consumption were conducted on a random sample of youth for each meal. ANALYSIS: Descriptive analyses and t-tests were conducted to assess differences in satisfaction with and consumption of standard and lower GI foods. RESULTS: Lower GI foods served at dinner and for snacks received satisfaction ratings equal to standard foods (dinner: 3.68 lower GI versus 3.79 standard, P = .30; snacks: 3.74 lower GI versus 3.79 standard, P = .60). Lower GI foods served at breakfast and lunch received lower, though very acceptable, ratings (breakfast: 3.76 lower GI versus 4.04 standard, P < .01; lunch: 3.64 lower GI versus 3.88 standard, P = .01). Consumption of all meals was acceptable. No differences occurred in the frequency of high or low blood sugars between standard and lower GI days. CONCLUSIONS AND IMPLICATIONS: Higher quality carbohydrates may be provided to youth in institutional settings while maintaining sufficient levels of acceptability; specific findings are instructive for designing efforts to increase their consumption.

Adolescent↗

PubMed2005

Energy adaptation to glucocorticoid-induced hyperleptinemia in human beings.

Recombinant leptin therapy potently decreases food intake and body weight in aleptinemic individuals with leptin gene mutations. However, it is unknown whether manipulation of endogenous leptin secretion alters ingestive behavior in otherwise healthy subjects. We therefore assessed energy consumption during administration of hydrocortisone (HC), a known leptin secretagogue. Six healthy adults were admitted overnight on 2 occasions and given HC (12.5 mg/h IV) or saline infusion for 24 hours (8:00 am -8:00 am ) in a randomized crossover design. Total energy and macronutrient intake was calculated using a computerized nutrient analysis program. Blood sampling for measurement of leptin, cortisol, glucose, and insulin was performed at baseline and every 1 to 2 hours. A rise in plasma leptin level was noted after approximately 5 hours of HC infusion and was sustained throughout the study period. The total energy consumed was 3004 +/- 231 kcal for saline and 2486 +/- 214 kcal for HC ( P = .005); breakfast energy values on day 1 were similar but energy values consumed at lunch, dinner, and day 2 breakfast were all significantly lower during induced hyperleptinemia. Analysis of macronutrients indicated significant decreases in carbohydrate and fat intake during glucocorticoid-induced hyperleptinemia as compared with placebo. These results indicate that stimulation of native leptin secretion decreases energy consumption, similar to the effect observed with recombinant leptin therapy. To our knowledge, this is the first report documenting anti-ingestive responses to a leptin secretagogue. Because chronic glucocorticoid therapy is fraught with adverse effects, we suggest that nonsteroidal or steroidomimetic leptin secretagogues may be good candidates for anorectic and antiobesity drug development.

Blood Glucose↗

PubMed2007

Effects of a palatinose-based liquid diet (Inslow) on glycemic control and the second-meal effect in healthy men.

Postprandial hyperglycemia induces prolonged hyperinsulinemia, which is a risk factor for type 2 diabetes mellitus. Foods with a low glycemic index blunt the rapid rise in postprandial plasma glucose and insulin levels. We herein investigated the effects of a novel, palatinose-based liquid diet (Inslow, Meiji Dairy Products, Tokyo, Japan) on postprandial plasma glucose and insulin levels and on the rate of substrate oxidation in 7 healthy men. Furthermore, to examine the effects of Inslow on the second-meal effect, we quantified our subjects' postprandial plasma glucose, insulin, and free fatty acid levels for up to 7 hours after they ingested a breakfast containing Inslow or control formula, followed by a standard lunch 5 hours later. Our results showed that peak plasma glucose and insulin levels 30 minutes after Inslow loading were lower than after control formula loading. Postprandial fat oxidation rates in the Inslow group were higher than in the control formula group (P < .05). In the second-meal effect study, plasma glucose and insulin levels after lunch in the Inslow group were lower than in the control formula group (P < .01), although the peak levels in these groups were not different. The free fatty acid concentration in the Inslow group immediately before lunch was significantly lower than in the control formula group (P < .05). In conclusion, consumption of Inslow at breakfast appears to improve patient glycemic control by reducing their postprandial plasma glucose and insulin levels after lunch (second-meal effect).

Adult↗

PubMed2006

Food items consumed by students attending schools in different socioeconomic areas in Cape Town, South Africa.

OBJECTIVE: We investigated the food consumption patterns of adolescent students at schools. Our findings are intended to reveal the overall nutritional quality of foods eaten by students at school, including foods brought to school and foods purchased at school. METHODS: A questionnaire was completed by 476 students, mostly from grades 7 and 10, from 14 schools in Cape Town, South Africa. The schools were representative of the various ethnic groups and socioeconomic strata of the population. The questionnaire requested information on eating habits at school, foods brought to school and food purchases, and breakfast consumption before school. We also tested whether students knew which foods are healthy and which are less healthy choices. RESULTS: The students were mostly 12 to 16 y of age (mean age 14.5 y). The large majority had breakfast before school (77.8%) and ate at school (79.7%). Food was brought to school by 41% to 56%, whereas 69.3% purchased food at school, mainly at the school store (tuck shop). Predefined "unhealthy" foods brought to school outnumbered "healthy" ones by 2 to 1. Among students who purchased food at school, 70.0% purchased no healthy items, whereas 73.2% purchased two or more unhealthy items. With six foods 84% of students correctly stated whether they were healthy or unhealthy; however, with cola drinks, samoosas (deep-fried pastry with spicy filling), and pies, only 47% to 61% knew that these were less healthy choices. Students' scores on this question were unrelated to whether they purchased healthy or unhealthy foods. Students who attended schools of high socioeconomic status were twice as likely to bring food to school (64.7% versus 31.0%, P<0.001), scored higher marks on the quiz of healthy versus unhealthy foods (P<0.01), but were no more likely to purchase healthy food. CONCLUSIONS: The large majority of food eaten by adolescent students in Cape Town is classified as being unhealthy choices. This applies to foods brought to school and food purchases. Consideration needs to be given to policy measures to improve this situation and to improve education of students and their parents.

Adolescent↗